MEDICARE: REID PHYSICIAN ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15-3896	OTHER	IN	OSCAR
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154324630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REID PHYSICIAN ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	1100 REID PKWY
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1157
Country	:	US
Telephone Number	:	765-478-6108
Fax Number	:	765-478-1243

Provider Business Practice Location Address
First Line	:	1154 S STATE ROAD 1 STE 1
Second Line	:
City	:	CAMBRIDGE CITY
State	:	IN
Zip	:	47327-9472
Country	:	US
Telephone Number	:	765-478-6108
Fax Number	:	765-478-1243

Authorized Official
Title or Position	:	CEO
Name	:	CRAIG C. KINYON
Credential	:
Telephone Number	:	765-935-8806

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	06/09/2020

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